The Asthma Control Test (ACT) as a predictor of GINA guideline-defined asthma control

analysis of a multinational cross-sectional survey

Mike Thomas, Stephen Kay, James Pike, Angela Williams, Jacqueline R Carranza Rosenzweig, Elizabeth V Hillyer, David Price

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

AIMS: To evaluate whether the Asthma Control TestTM (ACT) score is predictive of Global Initiative for Asthma (GINA) guideline-defined classification levels of asthma control. The ACT is a validated, 5-item, patient-completed measure of asthma control with a recall period of four weeks. METHODS: Cross-sectional survey comparing ACT score and GINA classification of asthma control among 2949 patients attending primary care physicians and specialists in France, Germany, Italy, Spain, the UK, and the USA. RESULTS: The area under the receiver operating characteristics curve for ACT score predicting GINA control was 0.84 (95% CI 0.82–0.85). An ACT score of <19 (not well-controlled asthma) correctly predicted GINA-defined partly controlled/uncontrolled asthma 94% of the time, while an ACT score of >20 predicted GINA-defined controlled asthma 51% of the time, with kappa statistic of 0.42, representing moderate agreement. CONCLUSIONS: An ACT score <19 is useful for identifying patients with poorly controlled asthma as defined by GINA.
Original languageEnglish
Pages (from-to)41-49
Number of pages9
JournalPrimary Care Respiratory Journal
Volume18
Issue number1
DOIs
Publication statusPublished - 1 Mar 2009

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Asthma
Cross-Sectional Studies
Guidelines
Primary Care Physicians
ROC Curve
Spain
Italy
France
Germany

Keywords

  • adolescent
  • adult
  • aged
  • aged, 80 and over
  • anti-asthmatic agents
  • asthma
  • child
  • cross-sectional studies
  • Europe
  • female
  • humans
  • male
  • middle aged
  • patient satisfaction
  • physicians
  • practice guidelines as topic
  • predictive value of tests
  • ROC curve
  • severity of illness index
  • treatment outcome
  • United States
  • young adult

Cite this

The Asthma Control Test (ACT) as a predictor of GINA guideline-defined asthma control : analysis of a multinational cross-sectional survey. / Thomas, Mike; Kay, Stephen; Pike, James; Williams, Angela; Rosenzweig, Jacqueline R Carranza; Hillyer, Elizabeth V; Price, David.

In: Primary Care Respiratory Journal, Vol. 18, No. 1, 01.03.2009, p. 41-49.

Research output: Contribution to journalArticle

Thomas, Mike ; Kay, Stephen ; Pike, James ; Williams, Angela ; Rosenzweig, Jacqueline R Carranza ; Hillyer, Elizabeth V ; Price, David. / The Asthma Control Test (ACT) as a predictor of GINA guideline-defined asthma control : analysis of a multinational cross-sectional survey. In: Primary Care Respiratory Journal. 2009 ; Vol. 18, No. 1. pp. 41-49.
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abstract = "AIMS: To evaluate whether the Asthma Control TestTM (ACT) score is predictive of Global Initiative for Asthma (GINA) guideline-defined classification levels of asthma control. The ACT is a validated, 5-item, patient-completed measure of asthma control with a recall period of four weeks. METHODS: Cross-sectional survey comparing ACT score and GINA classification of asthma control among 2949 patients attending primary care physicians and specialists in France, Germany, Italy, Spain, the UK, and the USA. RESULTS: The area under the receiver operating characteristics curve for ACT score predicting GINA control was 0.84 (95{\%} CI 0.82–0.85). An ACT score of <19 (not well-controlled asthma) correctly predicted GINA-defined partly controlled/uncontrolled asthma 94{\%} of the time, while an ACT score of >20 predicted GINA-defined controlled asthma 51{\%} of the time, with kappa statistic of 0.42, representing moderate agreement. CONCLUSIONS: An ACT score <19 is useful for identifying patients with poorly controlled asthma as defined by GINA.",
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